Industry Admissions

Admissions:

• “This is so fraught with politics and money.”

• “I have worked, I have consulted with every MR pharmaceutical firm in the world that I’m aware of.”

• “Nobody's going to take gadolinium as an element and hand it to a human being — that is indeed toxic and so we're not gonna do that.” Speaker admits gadolinium is too toxic to hand to a person, yet justifies injecting it into a person’s bloodstream.

• The speaker uses metaphorical language to lessen the blow of injecting something toxic: “What they do is they take the gadolinium and they marry it together. It's coupled to a chaperone molecule, a ligand, you know, like when a certain ligates something, ties it up. So a ligand molecule, ligature, is a tie, it's a knot. It ties them together.”

• The speaker acknowledges that the belief in full bodily excretion—the foundational premise for the approval of gadolinium contrast agents—is merely a “philosophy,” stating, “That’s been the philosophy until now.” However, the speaker omits that the correction of this faulty scientific premise emerged not through industry transparency, but through the relentless efforts of patients demanding the truth about the product's chemistry. Without the voices of those disabled by gadolinium, which led to the 2017 FDA meeting, this so-called “philosophy” would still dominate the industry, perpetuating a marketing campaign not based in reality.

• The speaker admits that gadolinium and its ligand latch onto biological molecules but uses “dot dot dot” to divert attention from the most harmful effects.

• Retained gadolinium exists in various forms (chelated, dissociated, or bound to macromolecules), posing risks and disrupting homeostasis.

• Fibrosis is a documented condition linked to gadolinium exposure.

• “For every agent out there, it [the amount of gadolinium retained in the body] is not zero.”

• The speaker openly admits, “I hate chemistry, I’m incompetent in chemistry, so that gives you a bit of an idea of who’s talking to you from a chemistry viewpoint.” From a patient’s perspective, this is deeply concerning. Radiologists, who lack expertise in chemistry, have the power to administer substances that can permanently alter a person’s biochemistry. Such a lack of understanding about the harmful effects of certain elements is unacceptable when it comes to patient safety and well-being.

• “There is no such thing as free gadolinium in a human.” Gadolinium instantaneously forms bonds with internal components of the human body when it is freed from its ligand.

• Gadolinium is water-insoluble and forms precipitates in the body, making urine excretion more difficult, if not impossible.

• A 1995 study found that gadolinium-based agents injected into the cerebrospinal fluid of rats caused neurotoxic effects, with macrocyclic agents proving more neurotoxic than linear agents. Dr. Kanal states, “Neurotoxicity is massively higher for the macrocyclic agents compared to the linear agents. We’ve known that for a couple of decades. See how marketing works? In the U.S., it’s illegal to say to somebody that a macrocyclic is safer than a linear... Can you please show me what the safer is applying to?”

• “It seems that every patient you inject contrast into, it gets into the CSF within a few hours.”

• The speaker admits, “I am not sure I would want macrocyclics in my brain.” This man, knowing of the risks of gadolinium, including gadolinium deposition disease due to patient outreach, says that his personal preference would be to not have macrocylics in his brain. Despite this, he did not speak out against them at the 2017 FDA meeting, continues to work with MRI contrast dye companies, and actively promotes a new gadopiclenol macrocyclic product, detailed below.

• Gadolinium deposits in the basal ganglia.

• Gadolinium can be detected on MRI in the brain and eyes days after injection. Considering precipitate formation, this could mean that metal shards of gadolinium would form in the eyes.

Omissions:

• “Gadolinium itself is an element like oxygen, like nitrogen, like carbon. It's a heavy metal; it's a lanthanide.” When those with conflicts of interest discuss gadolinium, they often compare it to familiar biological elements to make it seem more relatable or benign. In this lecture, Dr. Kanal likens gadolinium to nitrogen and oxygen, whereas a more accurate comparison would include elements such as ytterbium, cerium, and neodymium—fellow lanthanides with similar properties.

• The speaker claims that gadolinium dissociation occurs because it is “left in the body for too long.” However, recent evidence shows that dissociation can occur within seconds to minutes, depending on biological factors. If the speaker's assertion were correct, “too long” would equate to mere seconds or minutes—an impossibility given that the human body cannot fully excrete a substance in such a short time. This fact absolves patients' bodies from bearing the blame for gadolinium retention and its associated risks.

• The speaker admits that there are only a few dozen autopsies worldwide showing gadolinium deposition in the human brain. What he omits, however, is that this limited data is not due to rarity of brain deposition, but because the industry is not actively investigating gadolinium in the brain.

• The speaker highlights the urgent need for independent studies to assess the toxicological profiles of retained gadolinium in all its forms, but this puts onus on the patient and independent researchers to prove the toxicity of a drug, when it should be companies’ responsibility to prove the safety of their drug to the public first.

• The industry's claim of side effects being “unknown” or "needing more studies" on gadolinium retention stems from their choice not to investigate its long-term effects, not a lack of understanding because the industry has known about gadolinium’s toxicity for decades.